Outcomes of incidentally detected ovarian cancers diagnosed at time of risk-reducing salpingo-oophorectomy in BRCA mutation carriers Journal Article


Authors: Cowan, R.; Pedra Nobre, S.; Pradhan, N.; Yasukawa, M.; Zhou, Q. C.; Iasonos, A.; Soslow, R. A.; Arnold, A. G.; Trottier, M.; Catchings, A.; Roche, K. L.; Gardner, G.; Robson, M.; Abu Rustum, N. R.; Aghajanian, C.; Cadoo, K.
Article Title: Outcomes of incidentally detected ovarian cancers diagnosed at time of risk-reducing salpingo-oophorectomy in BRCA mutation carriers
Abstract: Objective: Prior data suggested that women with incidentally detected occult invasive ovarian cancer (OIOC) at the time of risk-reducing salpingo-oophorectomy (RRSO) for BRCA mutation may have poorer prognoses than would be expected based on disease stage. We sought to evaluate prevalence and outcomes of patients with OIOC in a tertiary referral center. Methods: Patients with BRCA mutation undergoing RRSO from 01/2005 to 05/2017 were identified, and their records reviewed. Women with incidentally detected OIOC were included; those with clinical features raising preoperative suspicion for malignancy were excluded. Results: 548 patients with BRCA mutation who underwent RRSO were identified. 26 (4.7%) had an OIOC (median age 55 years; range 42–75); 15(58%) patients, BRCA1; 9(34%), BRCA2; 2(8%) had a mutation in both genes. All OIOCs were high-grade serous: 10 (38%) Stage I; 8 (31%) Stage II; 8(31%) Stage III. 24(92%) patients received adjuvant platinum/taxane therapy. Of Stage III patients, 4 (50%) were identified intraoperatively; the remaining 4 (50%) had microscopic nodal disease on final pathology only. At median follow-up of 67.3 months (28–166) no Stage I patients have recurred; 2 Stage II and 6 Stage III patients recurred. 5-year progression-free survival (PFS) was 72% (95%CI, 50.2–85.7%); median PFS for the cohort was 129 months (95%CI, 75.3-not estimable). 5-year disease-specific survival (DSS) was 96% (95%CI, 76–99%); median DSS not reached. Conclusion: Consistent with prior reports, almost 5% of patients had an OIOC at RRSO. The majority with early-stage disease had excellent PFS and DSS outcomes, as would be expected based on disease stage. © 2021 Elsevier Inc.
Keywords: brca; risk-reducing surgery; occult ovarian cancer
Journal Title: Gynecologic Oncology
Volume: 161
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2021-05-01
Start Page: 521
End Page: 526
Language: English
DOI: 10.1016/j.ygyno.2021.02.006
PUBMED: 33712278
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 3 May 2021 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Ginger J Gardner
    204 Gardner
  2. Mark E Robson
    561 Robson
  3. Qin Zhou
    169 Zhou
  4. Alexia Elia Iasonos
    254 Iasonos
  5. Robert Soslow
    749 Soslow
  6. Angela Arnold
    38 Arnold
  7. Karen Anne Cadoo
    100 Cadoo
  8. Renee Antonette Woodburn Cowan
    30 Cowan
  9. Nisha Pradhan
    15 Pradhan